Self-expanding metal stents in malignant colonic obstruction

Experiences from Sweden

Mattias Lepsenyi, Stefan Santen, Ingvar Syk, Jörgen Nielsen, Artur Nemeth, E. Tóth, Henrik Thorlacius

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Acute surgery in the management of malignant colonic obstruction is associated with high morbidity and mortality. The use of self-expanding metal stents (SEMS) is an alternative method of decompressing colonic obstruction. SEMS may allow time to optimize the patient and to perform preoperative staging, converting acute surgery into elective. SEMS is also proposed as palliative treatment in patients with contraindications to open surgery. Aim: To review our experience of SEMS focusing on clinical outcome and complications. The method used was a review of 75 consecutive trials at SEMS on 71 patients based on stent-protocols and patient charts. Findings. SEMS was used for palliation in 64 (85%) cases and as a bridge to surgery in 11 (15%) cases. The majority of obstructions, 53 (71%) cases, were located in the recto-sigmoid. Technical success was achieved in 65 (87%) cases and clinical decompression was achieved in 60 (80%) cases. Reasons for technical failure were inability to cannulate the stricture in 5 (7%) cases and suboptimal SEMS placement in 3 (4%) cases. Complications included 4 (5%) procedure-related bowel perforations of which 2 (3%) patients died in junction to post operative complications. Three cases of bleeding after SEMS occurred, none of which needed invasive treatment. Five of the SEMS occluded. Two cases of stent erosion were diagnosed at the time of surgery. Average survival after palliative SEMS treatment was 6 months. Conclusion: Our results correspond well to previously published data and we conclude that SEMS is a relatively safe and effective method of treating malignant colonic obstruction although the risk of SEMS-related perforations has to be taken into account.

Original languageEnglish
Article number274
JournalBMC Research Notes
Volume4
DOIs
Publication statusPublished - 2011

Fingerprint

Stents
Sweden
Metals
Surgery
Sigmoid Colon
Decompression
Palliative Care
Erosion

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Self-expanding metal stents in malignant colonic obstruction : Experiences from Sweden. / Lepsenyi, Mattias; Santen, Stefan; Syk, Ingvar; Nielsen, Jörgen; Nemeth, Artur; Tóth, E.; Thorlacius, Henrik.

In: BMC Research Notes, Vol. 4, 274, 2011.

Research output: Contribution to journalArticle

Lepsenyi, Mattias ; Santen, Stefan ; Syk, Ingvar ; Nielsen, Jörgen ; Nemeth, Artur ; Tóth, E. ; Thorlacius, Henrik. / Self-expanding metal stents in malignant colonic obstruction : Experiences from Sweden. In: BMC Research Notes. 2011 ; Vol. 4.
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abstract = "Background: Acute surgery in the management of malignant colonic obstruction is associated with high morbidity and mortality. The use of self-expanding metal stents (SEMS) is an alternative method of decompressing colonic obstruction. SEMS may allow time to optimize the patient and to perform preoperative staging, converting acute surgery into elective. SEMS is also proposed as palliative treatment in patients with contraindications to open surgery. Aim: To review our experience of SEMS focusing on clinical outcome and complications. The method used was a review of 75 consecutive trials at SEMS on 71 patients based on stent-protocols and patient charts. Findings. SEMS was used for palliation in 64 (85{\%}) cases and as a bridge to surgery in 11 (15{\%}) cases. The majority of obstructions, 53 (71{\%}) cases, were located in the recto-sigmoid. Technical success was achieved in 65 (87{\%}) cases and clinical decompression was achieved in 60 (80{\%}) cases. Reasons for technical failure were inability to cannulate the stricture in 5 (7{\%}) cases and suboptimal SEMS placement in 3 (4{\%}) cases. Complications included 4 (5{\%}) procedure-related bowel perforations of which 2 (3{\%}) patients died in junction to post operative complications. Three cases of bleeding after SEMS occurred, none of which needed invasive treatment. Five of the SEMS occluded. Two cases of stent erosion were diagnosed at the time of surgery. Average survival after palliative SEMS treatment was 6 months. Conclusion: Our results correspond well to previously published data and we conclude that SEMS is a relatively safe and effective method of treating malignant colonic obstruction although the risk of SEMS-related perforations has to be taken into account.",
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